<!DOCTYPE html>
<html lang="en">

<head>
    <meta charset="UTF-8">
    <meta name="viewport" content="width=device-width, initial-scale=1.0">
    <meta http-equiv="X-UA-Compatible" content="ie=edge">
    <title>Request an Appointment || Clainc || Health & Medical HTML Template</title>
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    <meta name="theme-color" content="#ffffff">
    <link rel="stylesheet" href="css/style.css">
    <link rel="stylesheet" href="css/responsive.css">
</head>

<body>
    <div class="preloader"></div><!-- /.preloader -->
    <div class="page-wrapper">
        <section class="topbar-one">
            <div class="container">
                <ul class="topbar-one__contact">
                    <li class="topbar-one__contact-item"><a href="mailto:help@example.com"><i class="material-icons">email</i>help@example.com</a></li>
                    <li class="topbar-one__contact-item"><a href="callto:123456789101"><i class="material-icons">local_phone</i>1234&nbsp;&nbsp;5678&nbsp;&nbsp;9101</a></li>
                </ul><!-- /.topbar-one__contact -->
                <div class="topbar-one__buttons">
                    <select class="selectpicker topbar-one__language">
                        <option>En</option>
                        <option>Bn</option>
                        <option>Du</option>
                    </select>
                    <a href="appointment.html" class="topbar-one__btn">Get Appointment</a>
                </div><!-- /.topbar-one__buttons -->
            </div><!-- /.container -->
        </section><!-- /.topbar-one -->
        <header class="site-header header-one">
            <nav class="navbar navbar-expand-lg navbar-light header-navigation stricky">
                <div class="container clearfix">
                    <!-- Brand and toggle get grouped for better mobile display -->
                    <div class="logo-box clearfix">
                        <a class="navbar-brand" href="index.html">
                            <img src="images/resources/logo-1-1.png" class="main-logo" alt="Awesome Image" />
                        </a>
                        <button class="menu-toggler" data-target=".main-navigation">
                            <span class="fa fa-bars"></span>
                        </button>
                    </div><!-- /.logo-box -->
                    <!-- Collect the nav links, forms, and other content for toggling -->
                    <div class="main-navigation">
                        <ul class=" navigation-box">
                            <li class="current">
                                <a href="index.html">首页</a>
                                <ul class="submenu">
                                    <li><a href="index.html">首页一</a></li>
                                    <li><a href="index-2.html">首页二</a></li>
                                    <li><a href="index-3.html">首页三</a></li>
                                    <li><a href="index-4.html">首页四</a></li>
                                    <li><a href="dental-1.html">牙科一</a></li>
                                    <li><a href="dental-2.html">牙科二</a></li>
                                    <li><a href="blood-donation.html">血液捐赠</a></li>
                                    <li><a href="blood-donation.html">Header Versions</a>
                                        <ul class="submenu">
                                            <li><a href="index.html">Header One</a></li>
                                            <li><a href="index-2.html">Header Two</a></li>
                                            <li><a href="index-3.html">Header Three</a></li>
                                            <li><a href="dental-1.html">Header Four</a></li>
                                        </ul><!-- /.submenu -->
                                    </li>
                                </ul><!-- /.submenu -->
                            </li>
                            <li>
                                <a href="services.html">部门</a>
                            </li>
                            <li>
                                <a href="about-1.html">关于我们</a>
                                <ul class="submenu">
                                    <li><a href="about-1.html">关于一</a></li>
                                    <li><a href="about-2.html">关于两</a></li>
                                    <li><a href="about-3.html">关于三</a></li>
                                </ul><!-- /.submenu -->
                            </li>

                            <li>
                                <a href="#">页面</a>
                                <ul class="submenu">
                                    <li><a href="doctors.html">团队</a></li>
                                    <li><a href="history-slide.html">历史</a></li>
                                    <li><a href="faq.html">常见问题</a></li>
                                    <li><a href="appointment.html">预约</a></li>
                                </ul><!-- /.submenu -->
                            </li>
                            <li>
                                <a href="pharmacy.html">商店</a>
                                <ul class="submenu">
                                    <li><a href="pharmacy.html">商店页面</a></li>
                                    <li><a href="medicine-details.html">医学详情</a></li>
                                    <li><a href="cart.html">购物车页面</a></li>
                                    <li><a href="checkout.html">结账页面</a></li>
                                </ul><!-- /.submenu -->
                            </li>
                            <li><a href="notice.html">通知</a></li>
                            <li>
                                <a href="blog.html">博客</a>
                                <ul class="submenu">
                                    <li><a href="blog-1.html">博客一</a></li>
                                    <li><a href="blog-2.html">博客二</a></li>
                                    <li><a href="blog-details.html">博客详情</a></li>
                                </ul><!-- /.submenu -->
                            </li>
                            <li><a href="contact.html">联系</a></li>
                        </ul>
                    </div><!-- /.navbar-collapse -->
                    <div class="right-side-box">
                        <a class="header-one__shop-btn" href="checkout.html"><i class="material-icons">favorite_border</i> <span class="count">0</span></a>
                        <a class="header-one__shop-btn" href="pharmacy.html"><i class="material-icons">add_shopping_cart</i> <span class="count">0</span></a>
                    </div><!-- /.right-side-box -->
                </div>
                <!-- /.container -->
            </nav>
        </header><!-- /.header-one -->
        <section class="inner-banner" style="background-image: url(images/resources/inner-banner-1-3.jpg);">
            <div class="container">
                <h2 class="inner-banner__title">请求预约</h2>
                <ul class="thm-breadcrumb">
                    <li><a href="index.html">首页</a></li>
                    <li><span class="sep">/</span></li>
                    <li><span class="page-title">预约</span></li>
                </ul><!-- /.thm-breadcrumb -->                
            </div><!-- /.container -->
        </section><!-- /.inner-banner -->
        <section class="appointment-one appointment-one__appointment-page">
            <div class="container">
                <div class="inner-container">
                    <h3 class="appointment-one__title">获取预约</h3><!-- /.appointment-one__title -->
                    <form action="inc/sendemail.php" class="appointment-one__form contact-form-vaidated">
                        <div class="row align-items-end">
                            <div class="col-xl-5 col-lg-6">
                                <label class="appointment-one__label">你的名字</label>
                                <div class="appointment-one__form-group">
                                    <div class="appointment-one__icon">
                                        <i class="material-icons">person</i>
                                    </div><!-- /.appointment-one__icon -->
                                    <input type="text" name="name" class="appointment-one__field" placeholder="你的名字">
                                </div><!-- /.appointment-one__form-group -->
                            </div><!-- /.col-lg-5 -->
                            <div class="col-xl-4 col-lg-6">
                                <label class="appointment-one__label">年龄</label>
                                <div class="appointment-one__form-group">
                                    <div class="appointment-one__icon">
                                        <i class="material-icons">date_range</i>
                                    </div><!-- /.appointment-one__icon -->
                                    <input type="text" name="age" class="appointment-one__field datepicker" placeholder="你的年龄">
                                </div><!-- /.appointment-one__form-group -->
                            </div><!-- /.col-lg-4 -->
                            <div class="col-xl-3 col-lg-6">
                                <label class="appointment-one__label">性别</label>
                                <div class="appointment-one__form-group">
                                    <div class="appointment-one__icon">
                                        <i class="material-icons">person</i>
                                    </div><!-- /.appointment-one__icon -->
                                    <div class="appointment-one__switch-wrap">
                                        <input type="hidden" name="gender">
                                        <button class="appointment-one__switch active">男</button>
                                        <button class="appointment-one__switch">女</button>
                                    </div><!-- /.appointment-one__switch-wrap -->
                                </div><!-- /.appointment-one__form-group -->
                            </div><!-- /.col-lg-3 -->
                            <div class="col-xl-5 col-lg-6">
                                <label class="appointment-one__label">电话号码</label>
                                <div class="appointment-one__form-group">
                                    <div class="appointment-one__icon">
                                        <i class="material-icons">phone</i>
                                    </div><!-- /.appointment-one__icon -->
                                    <input type="text" name="phone" class="appointment-one__field" placeholder="电话号码">
                                </div><!-- /.appointment-one__form-group -->
                            </div><!-- /.col-lg-5 -->
                            <div class="col-xl-4 col-lg-6">
                                <label class="appointment-one__label">预约日期</label>
                                <div class="appointment-one__form-group">
                                    <div class="appointment-one__icon">
                                        <i class="material-icons">date_range</i>
                                    </div><!-- /.appointment-one__icon -->
                                    <input type="text" name="booking_date" class="appointment-one__field datepicker" placeholder="选择时间">
                                </div><!-- /.appointment-one__form-group -->
                            </div><!-- /.col-lg-4 -->
                            <div class="col-xl-3 col-lg-6">
                                <label class="appointment-one__label">时间段</label>
                                <div class="appointment-one__form-group">
                                    <div class="appointment-one__icon">
                                        <i class="material-icons">access_time</i>
                                    </div><!-- /.appointment-one__icon -->
                                    <div class="appointment-one__switch-wrap">
                                        <input type="hidden" name="schedule">
                                        <button class="appointment-one__switch">早上</button>
                                        <button class="appointment-one__switch active">晚上</button>
                                    </div><!-- /.appointment-one__switch-wrap -->
                                </div><!-- /.appointment-one__form-group -->
                            </div><!-- /.col-lg-3 -->
                            <div class="col-xl-5 col-lg-6">
                                <label class="appointment-one__label">部门</label>
                                <div class="appointment-one__form-group">
                                    <select class="selectpicker">
                                        <option>选择部门</option>
                                        <option>选择部门</option>
                                        <option>选择部门</option>
                                        <option>选择部门</option>
                                        <option>选择部门</option>
                                    </select>
                                </div><!-- /.appointment-one__form-group -->
                            </div><!-- /.col-lg-5 -->
                            <div class="col-xl-4 col-lg-6">
                                <label class="appointment-one__label">医生</label>
                                <div class="appointment-one__form-group">
                                    <select class="selectpicker">
                                        <option>Select Doctor</option>
                                        <option>Charlyn Jongebloed</option>
                                        <option>Cortney Savala</option>
                                        <option>Juliana Cherrington</option>
                                        <option>Cleotilde Sarette</option>
                                    </select>
                                </div><!-- /.appointment-one__form-group -->
                            </div><!-- /.col-lg-4 -->
                            <div class="col-xl-3 col-lg-12">
                                <button type="submit" class="appointment-one__btn thm-btn">提交请求</button>
                            </div><!-- /.col-lg-3 -->
                        </div><!-- /.row -->
                    </form>
                    <div class="result"></div><!-- /.result -->
                </div><!-- /.inner-container -->
            </div><!-- /.container -->
        </section><!-- /.appointment-one -->
    

        <section class="team-one">
            <div class="container">
                <div class="block-title text-center">
                    <h2 class="block-title__title">医生建议你</h2><!-- /.block-title__title -->
                    <p class="block-title__text">得病赶快就医<br>时间不等人不要等到病情恶化之后再来进行求医</p><!-- /.block-title__text -->
                </div><!-- /.block-title -->

                <div class="post-filter-one">
                    <div class="row align-items-center">
                        <div class="col-lg-3">
                            <select name="post-type"  class="selectpicker">
                                <option>部门</option>
                                <option>Department</option>
                                <option>Department</option>
                            </select>
                        </div><!-- /.col-lg-3 -->
                        <div class="col-lg-3">                            
                            <select name="post-type"  class="selectpicker">
                                <option>专家</option>
                                <option>Specialist</option>
                                <option>Specialist</option>
                            </select>
                        </div><!-- /.col-lg-3 -->
                        <div class="col-lg-6">
                            <div class="post-filter-one__search">
                                <input type="text" name="search" placeholder="Type here for Search....">
                                <button type="submit"><i class="material-icons">搜索</i></button>
                            </div><!-- /.post-filter-one__search -->
                        </div><!-- /.col-lg-6 -->
                    </div><!-- /.row -->
                </div><!-- /.post-filter-one -->
                <div class="row low-gutters">
                    <div class="col-lg-3 col-md-6 col-sm-12">
                        <div class="team-one__single">
                            <div class="team-one__image">
                                <img src="images/team/team-1-1.jpg" alt="Awesome Image"/>
                            </div><!-- /.team-one__image -->
                            <div class="team-one__content">
                                <h3 class="team-one__title"><a href="#">Nidia Elland</a></h3><!-- /.team-one__title -->
                                <p class="team-one__speciality">Cardiologist</p><!-- /.team-one__speciality -->
                            </div><!-- /.team-one__content -->
                            <div class="team-one__hover-content">
                                <a class="team-one__hvr-link" href="#"><i class="material-icons">phone</i></a>
                                <a href="#" class="team-one__hvr-link"><i class="material-icons">email</i></a>
                            </div><!-- /.team-one__hover-content -->
                        </div><!-- /.team-one__single -->
                    </div><!-- /.col-lg-3 -->
                    <div class="col-lg-3 col-md-6 col-sm-12">
                        <div class="team-one__single">
                            <div class="team-one__image">
                                <img src="images/team/team-1-2.jpg" alt="Awesome Image"/>
                            </div><!-- /.team-one__image -->
                            <div class="team-one__content">
                                <h3 class="team-one__title"><a href="#">Dana Mastoris</a></h3><!-- /.team-one__title -->
                                <p class="team-one__speciality">Cardiologist</p><!-- /.team-one__speciality -->
                            </div><!-- /.team-one__content -->
                            <div class="team-one__hover-content">
                                <a class="team-one__hvr-link" href="#"><i class="material-icons">phone</i></a>
                                <a href="#" class="team-one__hvr-link"><i class="material-icons">email</i></a>
                            </div><!-- /.team-one__hover-content -->
                        </div><!-- /.team-one__single -->
                    </div><!-- /.col-lg-3 -->
                    <div class="col-lg-3 col-md-6 col-sm-12">
                        <div class="team-one__single">
                            <div class="team-one__image">
                                <img src="images/team/team-1-3.jpg" alt="Awesome Image"/>
                            </div><!-- /.team-one__image -->
                            <div class="team-one__content">
                                <h3 class="team-one__title"><a href="#">Calista Raxter</a></h3><!-- /.team-one__title -->
                                <p class="team-one__speciality">Cardiologist</p><!-- /.team-one__speciality -->
                            </div><!-- /.team-one__content -->
                            <div class="team-one__hover-content">
                                <a class="team-one__hvr-link" href="#"><i class="material-icons">phone</i></a>
                                <a href="#" class="team-one__hvr-link"><i class="material-icons">email</i></a>
                            </div><!-- /.team-one__hover-content -->
                        </div><!-- /.team-one__single -->
                    </div><!-- /.col-lg-3 -->
                    <div class="col-lg-3 col-md-6 col-sm-12">
                        <div class="team-one__single">
                            <div class="team-one__image">
                                <img src="images/team/team-1-4.jpg" alt="Awesome Image"/>
                            </div><!-- /.team-one__image -->
                            <div class="team-one__content">
                                <h3 class="team-one__title"><a href="#">Tamra Du</a></h3><!-- /.team-one__title -->
                                <p class="team-one__speciality">Cardiologist</p><!-- /.team-one__speciality -->
                            </div><!-- /.team-one__content -->
                            <div class="team-one__hover-content">
                                <a class="team-one__hvr-link" href="#"><i class="material-icons">phone</i></a>
                                <a href="#" class="team-one__hvr-link"><i class="material-icons">email</i></a>
                            </div><!-- /.team-one__hover-content -->
                        </div><!-- /.team-one__single -->
                    </div><!-- /.col-lg-3 -->
                    <div class="col-lg-3 col-md-6 col-sm-12">
                        <div class="team-one__single">
                            <div class="team-one__image">
                                <img src="images/team/team-1-5.jpg" alt="Awesome Image"/>
                            </div><!-- /.team-one__image -->
                            <div class="team-one__content">
                                <h3 class="team-one__title"><a href="#">Kip Sanfratello</a></h3><!-- /.team-one__title -->
                                <p class="team-one__speciality">Cardiologist</p><!-- /.team-one__speciality -->
                            </div><!-- /.team-one__content -->
                            <div class="team-one__hover-content">
                                <a class="team-one__hvr-link" href="#"><i class="material-icons">phone</i></a>
                                <a href="#" class="team-one__hvr-link"><i class="material-icons">email</i></a>
                            </div><!-- /.team-one__hover-content -->
                        </div><!-- /.team-one__single -->
                    </div><!-- /.col-lg-3 -->
                    <div class="col-lg-3 col-md-6 col-sm-12">
                        <div class="team-one__single">
                            <div class="team-one__image">
                                <img src="images/team/team-1-6.jpg" alt="Awesome Image"/>
                            </div><!-- /.team-one__image -->
                            <div class="team-one__content">
                                <h3 class="team-one__title"><a href="#">Melina Stellman</a></h3><!-- /.team-one__title -->
                                <p class="team-one__speciality">Cardiologist</p><!-- /.team-one__speciality -->
                            </div><!-- /.team-one__content -->
                            <div class="team-one__hover-content">
                                <a class="team-one__hvr-link" href="#"><i class="material-icons">phone</i></a>
                                <a href="#" class="team-one__hvr-link"><i class="material-icons">email</i></a>
                            </div><!-- /.team-one__hover-content -->
                        </div><!-- /.team-one__single -->
                    </div><!-- /.col-lg-3 -->
                    <div class="col-lg-3 col-md-6 col-sm-12">
                        <div class="team-one__single">
                            <div class="team-one__image">
                                <img src="images/team/team-1-7.jpg" alt="Awesome Image"/>
                            </div><!-- /.team-one__image -->
                            <div class="team-one__content">
                                <h3 class="team-one__title"><a href="#">Tanja Ruvalcaba</a></h3><!-- /.team-one__title -->
                                <p class="team-one__speciality">Cardiologist</p><!-- /.team-one__speciality -->
                            </div><!-- /.team-one__content -->
                            <div class="team-one__hover-content">
                                <a class="team-one__hvr-link" href="#"><i class="material-icons">phone</i></a>
                                <a href="#" class="team-one__hvr-link"><i class="material-icons">email</i></a>
                            </div><!-- /.team-one__hover-content -->
                        </div><!-- /.team-one__single -->
                    </div><!-- /.col-lg-3 -->
                    <div class="col-lg-3 col-md-6 col-sm-12">
                        <div class="team-one__single">
                            <div class="team-one__image">
                                <img src="images/team/team-1-8.jpg" alt="Awesome Image"/>
                            </div><!-- /.team-one__image -->
                            <div class="team-one__content">
                                <h3 class="team-one__title"><a href="#">Robbie Boot</a></h3><!-- /.team-one__title -->
                                <p class="team-one__speciality">Cardiologist</p><!-- /.team-one__speciality -->
                            </div><!-- /.team-one__content -->
                            <div class="team-one__hover-content">
                                <a class="team-one__hvr-link" href="#"><i class="material-icons">phone</i></a>
                                <a href="#" class="team-one__hvr-link"><i class="material-icons">email</i></a>
                            </div><!-- /.team-one__hover-content -->
                        </div><!-- /.team-one__single -->
                    </div><!-- /.col-lg-3 -->
                </div><!-- /.row -->
            </div><!-- /.container -->
        </section><!-- /.team-one -->

        <footer class="footer-one">
            <div class="footer-one__top">
                <div class="container">
                    <div class="row">
                        <div class="col-lg-2 col-md-6 col-sm-12">
                            <div class="footer-one__widget footer-one__link-widget">
                                <h3 class="footer-one__widget-title">导航</h3><!-- /.footer-one__widget-title -->
                                <ul class="footer-one__links-list">
                                    <li><a href="#">首页</a></li>
                                    <li><a href="#">关于我们</a></li>
                                    <li><a href="#">部门</a></li>
                                    <li><a href="#">医生</a></li>
                                    <li><a href="#">日志</a></li>
                                    <li><a href="#">联系</a></li>
                                </ul><!-- /.footer-one__links-list -->
                            </div><!-- /.footer-one__widget -->
                        </div><!-- /.col-lg-2 -->
                        <div class="col-lg-2 col-md-6 col-sm-12">
                            <div class="footer-one__widget footer-one__link-widget">
                                <h3 class="footer-one__widget-title">快速链接</h3><!-- /.footer-one__widget-title -->
                                <ul class="footer-one__links-list">
                                    <li><a href="#">获取预约</a></li>
                                    <li><a href="#">我们的医生团队</a></li>
                                    <li><a href="#">部门服务</a></li>
                                    <li><a href="#">关于医院</a></li>
                                    <li><a href="#">联系</a></li>
                                    <li><a href="#">获取报告</a></li>
                                </ul><!-- /.footer-one__links-list -->
                            </div><!-- /.footer-one__widget -->
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